| NPI | 1518145200 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: FL CH8822) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NC 2945) |
| Enumeration Date | 2008-02-05 |
| Last Update Date | 2024-04-30 |